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Explaining the Use of Experts to Resolve Claims 

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When the investigation is complete the adjuster must determine if  assistance is needed from liability experts, medical experts, or legal  counsel, or if it is better to rely on the layperson\\u2019s understanding of  physics, medicine, or other special areas involved in the particular  case.  Because a bad faith claim challenges the reasonableness of an insurer\\u2019s  conduct in investigating and adjusting a claim, the insurance company\\u2019s  conduct is judged objectively, using proof of industry standards.  [Travelers Ins. Co. v. Savio, 706 P.2d 1258, 1274 (Colo. 1985)].  

In a case where nothing in the record convinced the court that jurors  are familiar with the Boeckh Cost Guide or Xactimate or the how and when  of its general use. The alleged negligence in this case involves  technical knowledge of the insurance industry and industry practices.  Expert testimony was required to establish the standard of care. Because  the plaintiffs failed to provide the requisite expert testimony, there  was insufficient proof concerning the standard of care. Thus, the jury\\u2019s  verdict cannot be sustained. [Konrady v. Bremer Insurance Agencies, 639  N.W.2d 224, 249 Wis. 2d 489 (Wis. App., 2001)]  It is appropriate and, indeed, often required to use an expert to  establish insurance industry standards at trial. The opinion of an  independent, unbiased expert who is paid a reasonable fee can be helpful  to the investigation.  The Independent Medical Examination (IME)  When a claimant claims an injury that does not agree with the facts of  the incident claimed to have caused the injury, the adjuster will often  seek the assistance of an Independent Medical Examiner (IME) to verify  the extent of the claimed injury. The IME is usually a forensic  physician or a chiropractor who has agreed to evaluate an injured person  for a fee and is not involved in the treatment of the injured person.  In Pennsylvania, an insurer providing medical benefits to its insureds  following an automobile accident did not have to establish good cause  before the insureds were required to take physical examination  administered by doctor of insurer\\u2019s choice, even though statute provided  generally that insurer seeking to compel independent medical exam was  required to show good cause; policy gave insurer right to order  examination without establishing good cause. [Fleming v. CNA Ins.  Companies, 409 Pa. Super. 285, 597 A.2d 1206 (1991)].